Generic Submission for Formative Research, Pre-testing, Stakeholder Measures and Advocate Forms at NCI

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 1 Research Advocate System	Form and Instruction	New	Available
SSB_Generic Pretesting and Customer_3-9-2011.doc	Supporting Statement B	Uploaded 2011-05-19	Available
Attach 9_PIA.DOC	Supplementary Document	Uploaded 2011-05-19	Available
Attach 8_Privacy Act Memo.pdf	Supplementary Document	Uploaded 2011-05-19	Available
Attach 7_Advocates Research Working Group (ARWG) Members.pdf	Supplementary Document	Uploaded 2011-05-19	Available
Attach 6_Benefits of Advocacy in Research.doc	Supplementary Document	Uploaded 2011-05-19	Available
Attach 5_Reflections and Directions Interviews Focus Groups_CARRA.pdf	Supplementary Document	Uploaded 2011-05-19	Available
Attach 4_PostTest for Advocates_CARRA.doc	Supplementary Document	Uploaded 2011-05-19	Available
Attach 3_PreTest for Advocates_CARRA.doc	Supplementary Document	Uploaded 2011-05-19	Available
Attach 2_OAR PostActivity Survey for Staff.doc	Supplementary Document	Uploaded 2011-05-19	Available
Attach 1_OAR PostActivity Survey for Advocates.doc	Supplementary Document	Uploaded 2011-05-19	Repair queued
Cover Memo_OAR.doc	Supplementary Document	Uploaded 2011-05-19	Available
SSA_Generic Pretesting and Customer_5-13-2011.docx	Supporting Statement A	Uploaded 2011-05-19	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
212181	Research Advocate System	Form and Instruction	New

ICR Details

OMB Control No: 0925-0641	ICR Reference No: 201106-0925-002
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/NIH	Agency Tracking No:
Title: Generic Submission for Formative Research, Pre-testing, Stakeholder Measures and Advocate Forms at NCI
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 09/01/2011
	Date Received in OIRA: 06/07/2011
Terms of Clearance: This generic ICR is approved consistent with NIH agreement to submit individual colletions to OMB as they are implemented, along with all necessary supporting statements (to include information about research design and analysis, incentives, burden estimates, approaches to address non-response bias, etc). OMB will aim to review each IC submission within 14 days; however, OMB approval should not be assumed if not explicitly granted, even if 14 days have elapsed since submission. Approval for this generic ICR should not be construed as approval for this particular IC.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	09/30/2014	36 Months From Approved
Responses	5,925	0	0
Time Burden (Hours)	3,675	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: This is a request for OMB to approve this generic submission package on behalf of the NCI Office of Advocacy Relations (OAR). In addition to collecting information for research and customer service, OAR will request information from advocates in order to match them appropriately to NCI activities based on their interest and experience. Approval is requested for the conduct of multiple studies annually using such methods as interviews, focus groups, and various types of surveys.

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Authorizing Statute(s): US Code: 42 USC 285a-1 Name of Law: Public Health Service Act
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	76 FR 14034	03/15/2011
30-day Notice:	Federal Register Citation:	Citation Date:
	76 FR 28994	05/19/2011
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

table that charts list of burden

IC Title	Form No.	Form Name
Research Advocate System	2, 1	Registration/Annual Update Form ,   Telephone Screening Form

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ICR Summary of Burden

table that charts list of burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	5,925	0	0	5,925	0	0
Annual Time Burden (Hours)	3,675	0	0	3,675	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: This is a new, generic collection of information.

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Annual Cost to Federal Government: $131,500

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 06/07/2011

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